Senate BillNo. 518


Introduced by Senator Leno

(Coauthor: Senator Hancock)

February 26, 2015


An act to amend Section 13963.1 of, and to add Sections 13963.2 and 13963.3 to, the Government Code, relating to victims of violent crimes.

LEGISLATIVE COUNSEL’S DIGEST

SB 518, as introduced, Leno. Victims of violent crimes: trauma recovery centers.

Existing law requires the California Victim Compensation and Government Claims Board to administer a program to assist state residents to obtain compensation for their pecuniary losses suffered as a direct result of criminal acts. Payment is made under these provisions from the Restitution Fund, which is continuously appropriated to the board for these purposes. Existing law requires the California Victim Compensation and Government Claims Board to administer a program to evaluate applications and award grants to trauma recovery centers funded by moneys in the Restitution Fund.

This bill would make legislative findings and would require the board to use the evidence-based Integrated Trauma Recovery Services model developed by the Trauma Recovery Center at San Francisco General Hospital University of California, San Francisco (UCSF TRC) when it provides grants to trauma recovery centers. This bill would also require the board, upon appropriation of funds by the Legislature, to enter into an interagency agreement with the Trauma Recovery Center of the Regents of the University of California, San Francisco, to establish the UCSF TRC as the State of California’s Trauma Recovery Center of Excellence (TR-COE). The agreement provided for in this bill would require the TR-COE to support the board by defining the core elements of the evidence-based practice and providing training materials, technical assistance, and ongoing consultation and programming to the board and to each center to enable the grantees to replicate the evidence-based approach.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

Section 13963.1 of the Government Code is
2amended to read:

3

13963.1.  

(a) The Legislature finds and declares all of the
4following:

5(1) Without treatment, approximately 50 percent of people who
6survive a traumatic, violent injury experience lasting or extended
7psychological or social difficulties. Untreated psychological trauma
8often has severe economic consequences, including overuse of
9costly medical services, loss of income, failure to return to gainful
10employment, loss of medical insurance, and loss of stable housing.

11(2) Victims of crime should receive timely and effective mental
12health treatment.

13(3) The board shall administer a program to evaluate applications
14and award grants to trauma recovery centers.

15(b) The board shall award a grant only to a trauma recovery
16center that meetsbegin delete bothend deletebegin insert allend insert of the following criteria:

17(1) The trauma recovery center demonstrates that it serves as a
18community resource by providing services, including, but not
19limited to, making presentations and providing training to law
20enforcement, community-based agencies, and other health care
21providers on the identification and effects of violent crime.

22(2) Any other related criteria required by the board.

begin insert

23(3) The trauma recovery center uses the core elements
24established in Sections 13963.2 and 13963.3.

end insert

25(c) It is the intent of the Legislature to provide an annual
26appropriation of two million dollars ($2,000,000) per year. All
27grants awarded by the board shall be funded only from the
28Restitution Fund.

29(d) The board may award a grant providing funding for up to a
30maximum period of three years. Any portion of a grant that a
P3    1trauma recovery center does not use within the specified grant
2period shall revert to the Restitution Fund. The board may award
3consecutive grants to a trauma recovery center to prevent a lapse
4in funding. The board shall not award a trauma recovery center
5more than one grant for any period of time.

6(e) The board, when considering grant applications, shall give
7preference to a trauma recovery center that conducts outreach to,
8and serves, both of the following:

9(1) Crime victims who typically are unable to access traditional
10services, including, but not limited to, victims who are homeless,
11chronically mentally ill, of diverse ethnicity, members of immigrant
12and refugee groups, disabled, who have severe trauma-related
13symptoms or complex psychological issues, or juvenile victims,
14including minors who have had contact with the juvenile
15dependency or justice system.

16(2) Victims of a wide range of crimes, including, but not limited
17to, victims of sexual assault, domestic violence, physical assault,
18shooting, stabbing, and vehicular assault, and family members of
19homicide victims.

20(f) The trauma recovery center sites shall be selected by the
21board through a well-defined selection process that takes into
22account the rate of crime and geographic distribution to serve the
23greatest number of victims.

24(g) A trauma recovery center that is awarded a grant shall do
25both of the following:

26(1) Report to the board annually on how grant funds were spent,
27how many clients were served (counting an individual client who
28receives multiple services only once), units of service, staff
29productivity, treatment outcomes, and patient flow throughout
30both the clinical and evaluation components of service.

31(2) In compliance with federal statutes and rules governing
32federal matching funds for victims’ services, each center shall
33submit any forms and data requested by the board to allow the
34board to receive the 60 percent federal matching funds for eligible
35victim services and allowable expenses.

36(h) For purposes of this section, a trauma recovery center
37provides, including, but not limited to, all of the following
38resources, treatments, and recovery services to crime victims:

39(1) Mental health services.

P4    1(2) Assertive community-based outreach and clinical case
2management.

3(3) Coordination of care among medical and mental health care
4providers, law enforcement agencies, and other social services.

5(4) Services to family members and loved ones of homicide
6victims.

7(5) A multidisciplinary staff of clinicians that includes
8psychiatrists, psychologists, and social workers.

9

SEC. 2.  

Section 13963.2 is added to the Government Code, to
10read:

11

13963.2.  

(a) The Legislature finds and declares all of the
12following:

13(1) Victims of violent crime may benefit from access to
14structured programs of practical and emotional support. Research
15shows that evidence-based trauma recovery approaches are more
16effective, at a lesser cost, than customary fee-for-service programs.
17State-of-the-art fee-for-service funding increasingly emphasizes
18funding best practices, established through research, that can be
19varied but have specific core elements that remain constant from
20grantee to grantee. The public benefits when government agencies
21and grantees collaborate with institutions with expertise in
22establishing and conducting evidence-based services.

23(2) The Trauma Recovery Center at San Francisco General
24Hospital/University of California, San Francisco (UCSF TRC), is
25an award-winning, nationally recognized program created in 2001
26in partnership with the California Victim Compensation and
27Government Claims Board. The UCSF TRC was established by
28the Legislature as a four-year demonstration project to develop
29and test a comprehensive model of care as an alternative to
30fee-for-service care reimbursed by victim restitution funds. It was
31designed to increase access for crime victims to these funds.

32(3) The results of this four-year demonstration project have
33established that the UCSF TRC model was both clinically effective
34and cost effective when compared to customary fee-for-service
35care. Seventy-seven percent of victims receiving trauma recovery
36center services engaged in mental health treatment, compared to
3734 percent receiving customary care. The UCSF TRC model
38increased the rate by which sexual assault victims received mental
39health services from 6 percent to 71 percent, successfully linked
4053 percent to legal services, 40 percent to vocational services and
P5    131 percent to safer and more permanent housing. Trauma recovery
2center services cost 34 percent less than customary care.

3(b) The California Victim Compensation and Government
4Claims Board shall use the evidenced-based Integrated Trauma
5Recovery Services (ITRS) model developed by the UCSF TRC
6when it selects, establishes, and implements trauma recovery
7centers pursuant to Section 13963.1. In replicating programs funded
8by the California Victims Compensation and Government Claims
9Board, the ITRS can be modified to adapt to different populations,
10but it shall include the following core elements:

11(1) Provide outreach and services to crime victims who typically
12are unable to access traditional services, including, but not limited
13to, victims who are homeless, chronically mentally ill, of diverse
14ethnicity, members of immigrant and refugee groups, disabled,
15who have severe trauma-related symptoms or complex
16psychological issues, or juvenile victims, including minors who
17have had contact with the juvenile dependency or justice system.

18(2) Victims of a wide range of crimes, including, but not limited
19to, victims of sexual assault, domestic violence, physical assault,
20shooting, stabbing, and vehicular assault, human trafficking, and
21family members of homicide victims.

22(3) A structured evidence-based program of mental health and
23support services provided to victims of violent crimes or family
24members of homicide victims that includes crisis intervention,
25individual and group treatment, medication management, substance
26abuse treatment, case management, and assertive outreach. This
27care shall be provided in a manner that increases access to services
28and removes barriers to care for victims of violent crime. This
29includes providing services in the client’s home, in the community,
30or other locations outside the agency.

31(4) Staff shall include a multidisciplinary team of integrated
32trauma specialists that includes psychiatrists, psychologists, and
33social workers. The integrated trauma specialist shall be a licensed
34clinician, or a supervised clinician engaged in completion of the
35applicable licensure process. Clinical supervision and other support
36are provided to staff on a weekly basis to ensure the highest quality
37of care and to help staff deal constructively with vicarious trauma.

38(5) Psychotherapy and case management shall be provided by
39a single point of contact for the client, that is an individual trauma
40specialist, with support from an integrated trauma treatment team.
P6    1In order to ensure the highest quality of care, the treatment team
2shall collaboratively develop treatment plans in order to achieve
3positive outcomes for clients.

4(6) Services shall include assertive case management, including,
5but not limited to, a trauma specialist accompanying the client to
6court proceedings, medical appointments, or other community
7appointments as needed. Case management services shall include,
8but not be limited to, assisting clients file victim compensation
9applications, file police reports, help with obtaining safe housing
10and financial entitlements, linkages with medical care, assistance
11in return to work, liaison with other community agencies, law
12enforcement, and other support services as needed.

13(7) Clients shall not be excluded from services solely on the
14basis of emotional or behavioral issues resulting from trauma,
15including, but not limited to, substance abuse problems, low initial
16motivation, or high levels of anxiety.

17(8) Trauma recovery services shall incorporate established
18evidence-based practices, including, but not limited to, motivational
19interviewing, harm reduction, seeking safety, cognitive behavioral
20therapy, dialectical behavior, and cognitive processing therapy.

21(9) The goals of a Trauma Recovery Center shall be to decrease
22psychosocial distress, minimize long-term disability, improve
23overall quality of life, reduce the risk of future victimization, and
24promote post-traumatic growth.

25(10) In order to ensure that clients are receiving targeted and
26accountable services, treatment shall be provided up to 16 sessions.
27For those with ongoing problems and a primary focus on trauma,
28treatment may be extended after special consideration with the
29clinical supervisor. Extension beyond 32 sessions shall require
30approval by a clinical steering and utilization group that considers
31the client’s progress in treatment and remaining need.

32

SEC. 3.  

Section 13963.3 is added to the Government Code, to
33read:

34

13963.3.  

(a) The legislature finds and declares all of the
35following:

36(1) Systematic training, technical assistance, and ongoing
37standardized program evaluations are needed to ensure that all
38new state-funded trauma recovery centers are evidenced based,
39accountable, and clinically effective and cost effective.

P7    1(2) By creating a Trauma Recovery Center of Excellence
2(TR-COE), it is the intent of the Legislature that these services
3will be delivered in a clinically effective and cost effective manner,
4and that victims of crime in California will have increased access
5to needed services.

6(b) Upon appropriation of funds by the Legislature pursuant to
7subdivision (c), the board shall enter into an interagency agreement
8with the Trauma Recovery Center of the Regents of the University
9of California, San Francisco, to establish the UCSF TRC as the
10State of California’s Trauma Recovery Center of Excellence. This
11agreement shall require:

12(1) The board to consult with the TR-COE in developing
13language for grant applications and development of grant review
14criteria for grants pursuant to Section 13963.1.

15(2) The TR-COE to define the core elements of the
16evidence-based practice.

17(3) The board to consult with the TR-COE in the replication of
18the integrated trauma recovery services approach.

19(4) The TR-COE to assist by providing training materials,
20technical assistance, and ongoing consultation to the board and to
21each center to enable the grantees to replicate the evidence-based
22approach.

23(5) The TR-COE to assist in evaluation by designing and a
24multisite evaluation to measure adherence to the practice and
25effectiveness of each center.

26(c) This section does not apply to the University of California
27unless the Regents of the University of California, by appropriate
28resolution, make this section applicable.



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